Individual provider Active NPI

Karissa L Camarillo

  • Addiction (Substance Use Disorder) Counselor
  • Medford, OR
National Provider Identifier
1619888740
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
23-CRM-1616 Issued in OR
Practice address
211 W Main St
Medford, OR 97501-2728
Phone
(541) 772-1777
NPI assigned
Sep 16, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 23-CRM-1616 OR Primary

Addresses

Primary practice location

211 W Main St
Medford, OR 97501-2728

Mailing address

213 Edwards St
Medford, OR 97501-5846
Phone (541) 772-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1619888740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 EDWARDS ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015846",
            "telephone_number": "541-772-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012728",
            "telephone_number": "541-772-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARILLO",
        "first_name": "KARISSA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "23-CRM-1616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.